Kornimate/medical-research-clean huggingface dataset:
addition of dexmedetomidine to ropivacaine in bilateral erector spinae plane block in patients undergoing coronary artery bypass surgery

Conditions: Pain; Pain Management Following Cardiopulmonary Bypass Surgery; Erector Spinae Plane Block

Summary: coronary artery bypass surgery (cabg), typically performed through a median sternotomy, causes significant postoperative pain. managing this pain effectively while reducing reliance on opioids is essential, as opioids can lead to side effects such as respiratory depression, nausea, and potential for dependence. regional anesthesia techniques like the erector spinae plane block (espb) have emerged as promising tools to control pain and support recovery. this randomized, double-blind clinical trial evaluates whether adding dexmedetomidine, a sedative and analgesic, to ropivacaine, a local anesthetic, in bilateral espb can improve pain control after off-pump cabg surgery. the study is conducted at the lebanese american university medical center - rizk hospital. a total of 110 adult patients undergoing elective surgery are randomly assigned to one of two groups: 1. group r: receives ropivacaine alone in the espb. 2. group rd: receives ropivacaine with dexmedetomidine. the nerve block is administered before anesthesia. the primary outcome is the duration of effective pain relief (pain score ≤4) before the patient needs opioid medication, assessed up to 24 hours after extubation. secondary outcomes include: 1. pain scores monitored for up to 48 hours post-extubation 2. total intraoperative opioid use 3. time to extubation, ambulation, and incentive spirometry use 4. icu stay duration 5. side effects such as nausea, bradycardia, or local anesthetic toxicity this study supports efforts to reduce opioid use after heart surgery while maintaining effective pain management, aligning with enhanced recovery protocols and addressing the broader public health challenge of opioid overuse.


Eligibility criteria:
inclusion criteria: 1. age range: 25 - 80 years old 2. planned for elective off pump cabg 3. cognitively not impaired 4. american society of anesthesiologists class 3 5. left ventricular ejection fraction ≥40% 6. consent form for the study signed 7. no infection at the site of injection 8. no contraindication for esp block (thrombocytopenia, anticoagulation therapy) 9. no documented allergy to ropivacaine or dexmedetomidine exclusion criteria: 1. refusal to participate in the study 2. emergency surgery 3. american society of anesthesiologists class \>3 4. left ventricular ejection fraction \<40% 5. infection at the site of injection for ultrasound-guided espb 6. coagulation disorders 7. documented allergy to ropivacaine or dexmedetomidine 8. greater than first-degree heart block 9. bradycardia (heart rate \[hr\] \< 50 bpm) 10. pregnancy 11. bmi ≥40 12. psychiatric illnesses that would interfere with the assessment of pain scores 13. history of alcohol or drug abuse and chronic analgesic use
effect of intranasal insulin on postoperative cognitive dysfunction

Conditions: Middle Aged Patients

Summary: our study is designed to evaluate the effect of intranasal insulin on postoperative cognitive dysfunction. primary outcome: 1. the occurrence of cognitive dysfunction at approximately 7 days after surgery. secondary outcome: 1. incidence of any side effect.


Eligibility criteria:
inclusion criteria: 1. age 40 - 60 years. 2. both gender. 3. patients will be scheduled for elective major abdominal, thoracic, orthopedic, open gynecological, open urological, spine, otolaryngological surgeries under general anesthesia with expected hospital stay \>4 days. exclusion criteria: * 1. drug allergy. 2. patients with major psychiatric disease. 3. patients receive major tranquillizers and antidepressant. 4. those undergoing neurosurgery or cardiac surgery. 5. those unable or unwilling to abide by the study procedure 6. those who could not follow procedure or who had poor comprehension of dutch language. 7. those with sever visual and auditory disorder / handicaps.
duodenal cancer - retrospective analysis

Conditions: Duodenal Cancer

Summary: to see how a cohorte of 55 patients over periode 1997-2011 were mannaged, treated and survived duodenal cancer. also to see how advanced the tumors were at time of diagnose and at time of operation.


Eligibility criteria:
inclusion criteria: * duodenal cancer exclusion criteria: * other cancers of the upper gi tract such as pancreatic cancer, * cholangiocarcinoma, * papilla vateri cancer
risk factors for hepatic inflammation, fibrosis and prognosis in patients with chb and nafld

Conditions: Chronic Hepatitis b; Non-alcoholic Fatty Liver Disease

Summary: chronic hepatitis b (chb) affects an estimated 292 million people, and causes approximately 800,000 people deaths per year from liver-related complications including cirrhosis and hepatocellular carcinoma, remaining a major global public health issue.meanwhile, with the improvement of living standards and changes in lifestyle and dietary habits, non-alcoholic fatty liver disease (nafld) has become another important cause of liver cirrhosis and hcc.hbv combined with nafld inevitably develops into continuous or intermittent liver inflammation and fibrosis, which greatly increases the risk of cirrhosis, liver cancer and even end-stage liver disease. we aimed to investigate the risk factors and establish diagnostic models for hepatic inflammation, fibrosis in patients with chb associated nafld. in addition, to find risk factors for liver cirrhosis, liver cancer or liver failure in patients with chb-related nafld.

chronic hepatitis b (chb) affects an estimated 292 million people, and causes approximately 800,000 people deaths per year from liver-related complications including cirrhosis and hepatocellular carcinoma, remaining a major global public health issue.meanwhile, with the improvement of living standards and changes in lifestyle and dietary habits, non-alcoholic fatty liver disease (nafld) has become another important cause of liver cirrhosis and hcc.hbv combined with nafld inevitably develops into continuous or intermittent liver inflammation and fibrosis, which greatly increases the risk of cirrhosis, liver cancer and even end-stage liver disease. we aimed to investigate the risk factors and establish diagnostic models of hepatic inflammation and fibrosis in chb associated nafld patients using a multicenter study. in addition, to find risk factors for liver cirrhosis, liver cancer or liver failure in patients with chb-related nafld.

Eligibility criteria:
inclusion criteria: 1.18 years or older 2. positive hepatitis b surface antigen (hbsag) for at least 6 months and without other viral co-infection at baseline 2.nafld diagnosed by imaging liver biopsy, and/or blood testing/predictive indices exclusion criteria: 1. other chronic liver diseases, such as alcoholic liver disease, other viral hepatitis, drug-induced liver injury; 2. hcc or other malignancies before liver biopsy;

Keywords: chronic hepatitis b nonalcoholic fatty liver diabetes inflammation fibrosis prognosis
stereotactic radiotherapy plus temozolomide for refractory brain metastases

Conditions: Brain Metastases

Summary: this clinical trial was designed to investigate the efficiency and toxicity of fractionated stereotactic radiotherapy(fsrt) combined with temozolomide(tmz) for refractory brain metastases.

this is a single-arm, single center, phase ii trial to investigate the feasibility and toxicity of fsrt plus tmz for refractory brain metastases, which are defined as a: multiple brain metastases(≥3 lesions); b: large brain metastases(with one lesion's volume is no smaller than 6cc or the longest diameter is no shorter than 3cm); c: meningeal metastases.

Eligibility criteria:
inclusion criteria: * histologic or cytologic diagnosis of primary tumor and conformed brain metastases by enhanced mri or ct * the lesion number is no less than 3; or the tumor volume is no smaller than 6cc; or tumor diameter is no shorter than 3cm; or uncontrolled brain tumor after whole brain radiotherapy(wbrt); or the tumor is adjacent to essential structures of the brain, such as brain stem, optic chiasma, optic tract, etc. * kps ≥60，or kps ≥40 and the limitation of motion is simply caused by brain tumor that is adjacent to the motor function areas. * age: 18-75 years old. * adequate end-organ function: wbc≥4.0x109/l neu ≥ 1.5x109/l hemoglobin ≥ 110 g/l platelets ≥100 x109/l total bilirubin ≤ 1.5x uln ast and alt ≤ 1.5x uln bun and cr: within the normal range exclusion criteria: * other clinically significant diseases (e.g.myocardial infarction within the past 6 months, severe arrhythmia). * unable or unwilling to comply with the study protocol. * the expected survival time is less than 3 months. * patients who are anticipated in other clinical trials of brain metastases. * patients who has been treated with srt in other hospitals * pregnant patients or female patients whose hcg is positive * unsuitable to participate in study, that in the opinion of the treating physician.

Keywords: multiple brain metastases large brain metastases meningeal metastases fractionated stereotactic radiotherapy temozolomide
a phase ii clinical study of surufatinib combined with sintilimab in the treatment of advanced gastric cancer

Conditions: Gastric Adenocarcinoma

Summary: the efficacy and safety of the use of surufatinib in combination with sintilimab.


Eligibility criteria:
inclusion criteria: 1. patients must have the ability to understand and voluntarily sign informed consent; 2. age: 18-75 years old; 3. patients have histologically or cytologically confirmed advanced or recurrent gastric or gastroesophageal junction adenocarcinoma; 4. no previous therapy for advanced/metastatic disease of gc/gej and cps≥1; 5. patients have measurable disease as defined by recist 1.1 as determined by investigator; 6. eastern cooperative group (ecog) performance status of 0 to 2; 7. has adequate organ function; 8. expected survival period ≥ 3 months; 9. patients who not received a blood transfusion within 7 days of registration; 10. patients have recovered adverse events associated with chemotherapy, radiation and surgical operation as pretreatment to grade 1 or lower with ctcae v5.0 excluding stable symptoms (eg alopecia, peripheral sensory neuropathy, skin hyperpigmentation, dysgeusia etc.). 11. patients capable of taking oral medication; 12. female of childbearing potential who are negative in a pregnancy test within 7 days before enrollment. both male and female patients should agree to use an adequate method of contraception (total abstinence, an intrauterine device or hormone releasing system, an contraceptive implant and an oral contraceptive) starting with the first dose of study therapy through 6 months after the last dose of study therapy. duration will be determined when the subject is assigned to treatment. exclusion criteria: 1. patients who received prior anticancer treatment within 14 days (or 5 times the half-life time, whichever is shorter) or any investigational agent within 28 days prior to the first dose of study drugs. 2. patients who have undergone surgical treatment and radiotherapy with in 2 weeks before enrollment. 3. patients with a history of prior treatment with lenvatinib or any anti-programmed death 1 (anti-pd-1), anti-programmed ligand death 1 (anti-pd-l1), or anti-programmed ligand death 2 (anti-pd-l2 agent). 4. patients with symptomatic brain metastasis. 5. patients with hypertension that is difficult to control (systolic blood pressure ≥150 mmhg and diastolic blood pressure ≥100 mmhg) despite treatment with several hypotensive agents. 6. those who have received live vaccination within 4 weeks before the start of treatment. 7. patients with active hepatitis. 8. patients with a history of human immunodeficiency virus (hiv). 9. patients were judged unsuitable as subject of this trial by investigator.
modified dose and schedule of recombinant hepatitis b vaccination in hiv-infected adult subjects

Conditions: HIV Infection

Summary: the purposes of this study include 1) to compare the seroconversion rate of an intensive standard-dose regimen (0, 1, 2 and 6 months) to a standard-dose regimen (0,1 and 6 months), and 2) to compare the seroconversion rate of an intensive double-dose regimen (40 μg at 0,1,2 and 6 months) to a standard-dose regimen (20 μg at 0,1 and 6 months) of hbv vaccine in hiv-infected adult patients.

hiv and hbv share similar risk factors and routes of transmission. hiv/hbv coinfection is associated with greater chance of chronic hbv carrier state, higher level of hbv replication and increasing its potential for transmission. currently, there are no concrete data to determine the best hbv vaccination schedule in hiv-infected patients. standard hbv vaccination (20 μg at 0, 1 and 6 months) gives seroconversion rate of 33-63% in hiv-infected individuals compared with \>90% in healthy individuals. this study aims to compare the efficacy of an intensive standard-dose regimen (0, 1, 2 and 6 months) to a standard-dose regimen (0,1 and 6 months) and to compare the seroconversion rate of an intensive double-dose regimen (40 μg at 0,1,2 and 6 months) to a standard-dose regimen (20 μg at 0,1 and 6 months) of hbv vaccine in hiv-infected adult patients with cd4 level above 200 permm3 and suppressed viral load.

Eligibility criteria:
inclusion criteria: * positive for anti-hiv antibody * at least 18 years of age * cd4 \> 200 cell/mm3 * on antiretroviral therapy * viral load \< 50 copies/ml * negative for any hbv serological marker (hbsag, anti-hbs, anti-hbc) * no history of previous hepatitis b vaccination * anti-hcv negative * no active opportunistic infection at the time of screening * willing to sign informed consent * able to follow up exclusion criteria: * pregnancy or breast feeding * history of hypersensitivity to any component of vaccine * diagnosis of malignancy and receiving chemotherapy or radiation * other immunocompromised conditions not related to hiv infection (solid-organ transplantation, chemotherapy in the last 6 months) * on immunosuppressive treatment, immunomodulating treatment or corticosteroid (equal or above 0.5 mg per kg per day of prednisolone) * renal failure (creatinine clearance \< 30 ml/min) * decompensated cirrhosis (child-pugh c) * not able to follow up

Keywords: hepatitis b vaccine hiv infection modified hbv vaccine dose modified hbv vaccine schedule
a phase 1 pilot study of 99mtc-mip-1404 spect/ct imaging to histology in men with prostate cancer

Conditions: Prostate Cancer

Summary: this is a single arm, open label study of up to 24 prostate cancer patients scheduled for prostatectomy and/or pelvic lymph node dissection. patients receive a single iv dose of 99mtc-mip-1404 (study drug) followed by spect/ct scan 3-6 hours after injection. as standard of care, patients will undergo prostatectomy and/or pelvic lymph node dissection (plnd) within two weeks of study drug dosing. 99mtc-mip-1404 image data will be evaluated for visible uptake and compared with histopathology.


Eligibility criteria:
inclusion criteria: * male aged 21 years or older. * ability to provide signed informed consent and willingness to comply with protocol requirements. * past biopsy indicating the presence of adenocarcinoma of the prostate gland. * participant is deemed to have tissue suspicious of prostate cancer involvement that is amenable to biopsy/resection. * have had, or will undergo diagnostic ct or mri imaging prior to surgery. * participants must agree to use an acceptable form of birth control throughout the study period. participants must use condoms for a period of seven days after study drug administration, if engaged in sexual activity. exclusion criteria: * participants for whom participating would significantly delay the scheduled standard of care therapy. * participants administered a radioisotope within 5 physical half lives prior to study enrollment. * participants with any medical condition or other circumstances that, in the opinion of the investigator, would significantly decrease obtaining reliable data, achieving study objectives or completing the study.
anti-leukemia immune responses after irradiation of extramedullary tumors

Conditions: Acute Myeloid Leukemia; Myeloid Leukemia; Recurrent Acute Myeloid Leukemia

Summary: this clinical trial assesses how the immune system responds to leukemia tumors after low dose radiation delivered as part of standard of care. the information learned in this study may help them know if adding immunotherapy (a type of treatment that uses the immune system to fight cancer) can be helpful in future leukemia patients receiving radiation.

primary objectives: i. to identify changes in anti-leukemia immune responses after local radiotherapy to extramedullary sites. ii. develop an annotated biospecimen panel of extramedullary leukemia biopsies prior to and after radiotherapy to examine local immune responses using transcriptional profiling, immunofluorescence and single cell analyses. iii. define changes in the t cell receptor (tcr) clonotypes, functionality and inflammatory cytokine levels in peripheral blood leukocytes and serum. iv. correlate changes in anti-tumor immune responses with clinic-pathological variables and patient outcomes. secondary objectives: i. to assess the overall response rate (orr= complete response \[cr\] + partial response \[pr\]) of the extramedullary tumor treated with radiation therapy. ii. to assess the cr of extramedullary tumor treated with radiation therapy. iii. determine the duration of response (dor), event-free survival (efs). outline: patients undergo biopsy prior to radiation therapy and 7-14 days after radiation therapy. patients also undergo blood sample collection prior to therapy (within 7 days of starting radiation therapy), 1 and 7 days post completion of radiation therapy. patients' photographs of the biopsy site are taken before and at 4-6 weeks post completion of radiation, and their medical records are reviewed for up to 2 years.

Eligibility criteria:
inclusion criteria: * patients diagnosed with new or recurrent myeloid leukemia * aged \>= 18 years old * eastern cooperative oncology group (ecog) performance status \< 4 * patient have measurable and amenable to biopsy under local anesthesia without the need for imaging directed procedure * ability to understand and provide signed informed consent * females must be surgically or biologically sterile or postmenopausal (amenorrhoeic for at least 12 months) or if of childbearing potential, must have a negative serum or urine pregnancy test within 72 hours before the start of the treatment. women of childbearing potential must agree to use an adequate method of contraception during the study and until the last radiation treatment. males must be surgically or biologically sterile or agree to use an adequate method of contraception during the study and until the last radiation treatment exclusion criteria: * patients who are unwilling to participate * patients unwilling to undergo the biopsy before or after radiotherapy
post market clinical follow up (pmcf) medical device registry of z-systems zirconia dental products: z-systems registry

Conditions: Missing Teeth

Summary: commercially pure (cp) titanium is the gold standard to produce dental implants because it has a huge volume of scientific publications over a period of more than 50 years, it is cheap and simple to produce (i.e., making dental implants economically "affordable") and comes in numerous specific designs of screws for various indications. that is why more than 95% of the implant market is dominated by titanium. however, there is an innovation trend to manufacture implants from more inert and biocompatible materials. ceramic implants represent a valuable alternative for expanding the patient base of clinicians, especially in cases with challenging aesthetic demand. furthermore, there has been a significant increase in the number of patients requesting metal-free dentistry or bio-holistic implant treatments. in the past, ceramics were often branded as "inferior" quality due to its reputation as being brittle but the growing volume of scientific publications specifically on zirconia are demonstrating that it is comparable in fracture-strength with titanium implants. there is a clear market niche for zirconia implants, especially in cases of: * aesthetic reconstructions in the anterior region, especially in patients with a thin gingival biotype * gingival recessions where a white colored implant is a great advantage * for patients with a titanium intolerance/sensitivity * for patients who prefer a bio-holistic/metal-free dental approach. today, clinicians are asking for long-term clinical results of zirconia as a dental implant material. therefore, z-systems ag is conducting this zirconia dental implant registry. a registry design was chosen because it will capture long-term benefits/risks from clinical routine without patient selection.


Eligibility criteria:
inclusion criteria: * adult patient (≥ 18 years) was or will be implanted with up to 5 implants of the z-systems z5-bl or z5-tlproduct group * patient has signed informed consent. exclusion criteria: * none
a trial of skin care protocols for facial resurfacing

Conditions: Facial Photo Damage; Periocular Fine Wrinkles; Perioral Fine Wrinkles

Summary: the aims of the skin product assessment research study were to (1) develop an infrastructure and process for industry-sponsored, plastic surgery educational foundation (psef) research in facial aesthetic surgery and (2) test the research process by comparing outcomes of the obagi nu-derm system (odns) and conventional therapy as treatment adjuncts in ablative facial resurfacing.


Eligibility criteria:
inclusion criteria: * patients with moderate to severe photo damage and rhytids, undergoing full or partial face resurfacing with chemical peel or ablative laser. * fitzpatrick i-iv skin types exclusion criteria: * patients unable to complete the regimen or who had used topical prescription steroids, retinoids, depigmentation products or other products containing hydroquinone and polyhydroxy acids within 8 weeks of enrollment.

Keywords: moderate to severe facial photo damage periocular or perioral fine wrinkles
influence of wrist taping on handgrip strength in crossfit athletes

Conditions: Sport Injury; Hand Injury Wrist

Summary: the idea that the use of a wristband can increase the grip strength is old, but without systematic scientific evidence. most crossfit practitioners wear wrist bands during training because it is believed that the wristband increases the grip strength of the hand. the aim of this study is to to analyze the influence of the use of the wristband on the maximum force value and on the dynamic resistance of hand hold. a simple blind randomized cross-over trial will be performed.


Eligibility criteria:
inclusion criteria: * be an amateur practitioner of the crossfit modality with at least 6 months of regular sports practice (at least 4 times a week) * between 18-40 years old * agree to participate in the study and sign the informed consent form (icf). exclusion criteria: * active wrist/ arm injury or pain on the day of the test (pain score greater than 3 in 10 for both shoulder, forearm, wrist and / or hand on the vas pain scale) * history of wrist injury (especially fracture or ligament injury) * previous wrist surgery

Keywords: sports